1. Field of the Invention
The invention relates to the field of treatment of a mammal having exertional compartment syndrome and methods for confirming diagnosis of compartment syndrome resulting from vessel compression, overuse or other vascular stress, and more particularly to a method of non-surgically treating and confirming diagnosis of humans, including athletes, having exertional compartment syndrome.
2. Description of Related Art
Chronic exertional compartment syndrome, also known as exercise-induced compartment syndrome, is a disease that generally impacts athletes and can be debilitating. It is caused by reversible ischemia in an affected compartment. Various etiologies have been proposed, but the actual cause is believed not to have yet been proven. Typical treatment is fascial release of the affected compartment.
In the disease, the patient may feel pain, for example, in the calf which increasingly worsens with exercise. Exertional compartment syndrome is severely painful and more often than not affects high level athletes. The pain typically centers in the calf muscles and progressively worsens with higher levels of activity. The pain is sometimes described by patients as increasing pain and pressure under the skin. The symptoms can seem to the patient to get progressively worse but, in the case of advanced athletes, they may continue to train and exercise to meet goals.
It is believed that the symptoms of pain and tightness are the result of pressure that builds up within a muscle(s) of a patient, typically in a limb such as the leg or arm and most typically in the leg. As muscles are surrounded by tight tissue known as fascia, in normal use, the fascia has sufficient space for allowing muscles to function properly. However, in the case of athletes or other exertional use, as activity increases, so does blood flow to the muscle. Muscle size increases, but if the fascia is too constrictive, blood flow to the constricted muscle can be interrupted. Lack of blood flow leads to ischemia and associated pain.
Currently there are non-surgical steps to alleviate symptoms but no non-surgical treatments. Physicians may prescribe rest, physical therapy, or changes in exercise habits to alleviate symptoms, but these recommendations do not always work and do not treat the underlying disease.
If non-surgical recommendations for alleviating symptoms are ineffective, typical treatment is a surgery on the affected muscle compartment or compartments, which are generally in the leg. The surgery itself is not always successful with some patients having recurrent symptoms months to years later. Such surgery is the primary treatment of chronic exertional compartment syndrome, and currently the most effective. In the surgery, the physician operates on the fascia, the inelastic tissue encasing muscle compartments. A fasciotomy involves cutting open the fascia of each affected compartment. Alternatively, a surgery may include actually removing a portion of the fascia, known as a fasciectomy. The surgery is intended to release or decompress the area so the compartment can release pressure otherwise blocked by the fascia.
Complications of such surgeries include infections, nerve damage (which can be permanent) caused by inadvertent cutting or damage to nerves while undertaking the surgery, scarring and numbness in the area. There are also cosmetic issues in that muscles may appear to enlarge during exercise due to the lack of normal fascia containment.
Other non-surgical symptom treatments and/or preventative paths have also been suggested, including transdermal vitamin D3 treatment as described in International Patent Publication WO 2010/082837 A1 and use of preventative supplements to avoid the disease as described in U.S. Patent Publication No. 2006/0257503A1. The latter publication suggests a supplement for avoiding occurrence of compartment syndrome caused by a variety of pathways including exertional compartment syndrome in the forearm associated with “muscle pump” in professional motocross athletes. The publication describes a nutritional ingestible supplement mixture including magnesium chelate, malic acid, diethylglycine HCl and niacinamide which is intended to reduce the occurrence of the disease.
Much work has been done to improve diagnosis of the disease pathway (see, e.g. U.S. Pat. No. 7,381,186 directed to measuring pressure build-up in muscles). However, needs in the art still exist to confirm diagnosis and properly identify the etiology of the disease and also to provide better, more reliable, less invasive and preferably non-surgical treatment for compartment syndrome due to vessel compression, overuse, stress and the like, particularly exertional compartment syndrome.